Tuesday, June 15, 2010

The annual premium is only $2, but the system is propped up by foreign charities.

Of course, Americans will pay attention to this story less out of an inherent concern for Rwanda than because of how it reflects on us.

And each of us will see in the story what we want to see.

Liberals will point to it as evidence that the US has been maddeningly slow, relative to the rest of the world, to recognize health care as a basic human right.

Conservatives will gloat that this illustrates how hollow the concept of "universal health care" is. Just look at how paltry the services are in Rwanda, even though the system can be touted as "universal." Rwandan hospitals typically don't have running water. "[M]any things that are routine in the United States, like M.R.I. scans and dialysis, are generally unavailable."

But liberals can make their point without committing themselves to some implausible notion that health care is actually better in Rwanda. As the articles says:

Sunny Ntayomba, an editorial writer for The New Times, a newspaper based in the capital, Kigali, is aware of the paradox: his nation, one of the world’s poorest, insures more of its citizens than the world’s richest does.

He met an American college student passing through last year, and found it "absurd, ridiculous, that I have health insurance and she didn't," he said, adding: "And if she got sick, her parents might go bankrupt. The saddest thing was the way she shrugged her shoulders and just hoped not to fall sick."

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comments:

Rwandan medical care is limited by the nation's overall poverty: they just don't have the money for modern equipment or supplies. However, Rwandans use their clinics and hospitals readily and confidently, and the care is conscientious within the limits of the materials available. (I visited a one-year-old, from my adopted family, who was kept in hospital for five days to treat -- successfully -- a gastric infection; the long stay was deemed important to make sure she received all her antibiotics.) And as the NYT article correctly says, the pharmacies (which in the developing world often take the primary-care role) stock the entire standard pharmacopoeia and dispense advice. Modern medicine, not folk magic, is the first medical recourse for Rwandans, and that's important. The deficiencies are those of poverty across the world, rather than that particular nation. Standard warning: do not have a car accident in Africa!